ICD-10 B95.5
Billable / SpecificUnspecified streptococcus as the cause of diseases classified elsewhere
About ICD-10-CM B95.5
ICD-10-CM code B95.5 represents Unspecified streptococcus as the cause of diseases classified elsewhere. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block B95). The 2026 edition of ICD-10-CM B95.5 became effective on October 1, 2025.
Medicare LCD Coverage for B95.5
Local Coverage Determinations (LCDs) from CMS MACs that list B95.5 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing B95.5.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but B95.5 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with B95.5
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Convert B95.5 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| B95.5 | 04100 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To B95.5
Other codes in section B95-B97 (Bacterial and viral infectious agents).
ICD-10 B95.5, Billing FAQ
Is ICD-10 code B95.5 billable? +
Yes, B95.5 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What ICD-9 codes does B95.5 map to? +
Per CMS GEMs, B95.5 maps to ICD-9 codes: 04100. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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